It`s hard to resist the optimism

It would take some doing to recall a prior time that offered the kind of convergence of circumstances that is making so many people feel bullish about the addiction field's long-term health right now. Sure, media attention in the past has made addiction a “hot” topic for fleeting periods. But perhaps because of those ultimately dissatisfying experiences, the addiction community today is showing a greater ability to capitalize on being in the spotlight, even when they are forced to try to make something positive out of developments that have come across as negative (i.e., celebrity treatment center “hopping”).

The much-anticipated HBO documentary on addiction (equally valuable and moving for the most seasoned professional as for the general audience) was not an end in itself but a precursor to community-level organizing activities across the country. A freewheeling discussion held at a Rhode Island screening I attended in March left one participant asking if insurers who cut off coverage for substance abuse treatment could be charged with involuntary manslaughter for the worst of outcomes—a strategy articulated during gripping Pennsylvania legislative hearings shown in the HBO special.

Meanwhile, a refreshing optimism had infused the warm spring air in the nation's capital as well. As this issue was going to press, advocates for a comprehensive insurance parity bill could say for the first time in many years that substance abuse provisions weren't automatically being branded a “deal-breaker” that needed to be excluded from the discussion. And despite resistance toward feeling too enthusiastic about prospects for new federal funding initiatives, a strong coalition of treatment and justice officials was rallying behind offender reentry provisions in the Second Chance Act—an impressive bill that seeks to reflect the best thinking on how to reduce recidivism.

Of course, amid all the talk in the early part of 2007, the addiction community still shows that it must work hard to sharpen its message. A March 23 broadcast of Larry King Live featuring celebrities, treatment professionals, and government officials offered so many points of view on addiction and recovery that it could have led the most focused viewer to feel quite confused at the hour's end. In the same broadcast, viewers heard from various individuals that “treatment” is expensive but the best “treatment” out there (AA) is free; and that medications are showing great promise but even some of the treatment programs that have housed medication trials still proceed with extra caution in recommending their use. Not the clearest directions here by any means.

But at least there remains a sense right now that people are listening to what the experts of all persuasions are saying about addiction, treatment, and recovery. If there is any negative in all this, it could simply be that any losses the field could still experience on initiatives such as parity would strike an even harder blow against its collective psyche this year. After all, the prevailing sense might be, “If not now, when?”